التفاصيل البيبلوغرافية
| العنوان: |
Nailing the fibula: alternative or standard treatment for lateral malleolar fracture fixation? A broken paradigm. |
| المؤلفون: |
Giordano, Vincenzo, Boni, Guilherme, Godoy-Santos, Alexandre Leme, Pires, Robinson Esteves, Fukuyama, Junji Miller, Koch, Hilton A., Giannoudis, Peter V. |
| المصدر: |
European Journal of Trauma & Emergency Surgery; Dec2021, Vol. 47 Issue 6, p1911-1920, 10p, 3 Color Photographs, 1 Black and White Photograph, 1 Diagram, 4 Charts |
| مصطلحات موضوعية: |
RESEARCH, ORTHOPEDIC implants, ACQUISITION of data methodology, ANKLE fractures, FUNCTIONAL status, ENDOSCOPIC surgery, SURGERY, PATIENTS, RETROSPECTIVE studies, MEDICAL cooperation, FIBULA injuries, TREATMENT effectiveness, PHYSICAL activity, FRACTURE fixation, MEDICAL records, CASE studies, POSTOPERATIVE period, FIBULA, POSTOPERATIVE pain, PATIENT safety, EVALUATION |
| مستخلص: |
Purpose: Despite the fact that open reduction and internal fixation with a plate, either non-locked or locked, is the standard of care for managing lateral malleolus fractures, intramedullary (IM) fixation of the fibula has been recently introduced as an alternative, mainly for some potential complicated situations. We hypothesized that almost all patterns of distal fibula fracture can be safely fixed with an IM device, with the potential benefit of providing biomechanical efficiency, but using a soft-tissue friendly implant. Here, we present a multicenter case series based on a proposed algorithm. Patients and methods: Sixty-nine consecutive patients were managed with fibular IM fixation for closed malleolar fractures. Twenty patients were managed by IM screw fixation and 49 by fibular nailing. Outcome was measured both according to the American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle and hindfoot, and the time to bone union. Results: The mean AOFAS for Group I was 99.35 ± 1.95 points and that for Group II was 89.30 ± 16.98 points. There were no significant differences between the fracture pattern, according to the Lauge-Hansen classification, and post-operative levels of pain and functional activity among patients in both groups (p > 0.05). All fractures healed uneventfully in both groups. The mean time to union for Group I was 8.15 weeks and for Group II was 8.25 weeks (p > 0.05). Conclusion: In this multicenter case series, intramedullary fixation for the lateral malleolus fracture presented itself as a viable and safe option for the treatment of almost all patterns of fibula fracture in adults. Overall, we were able to demonstrate the potential indications of the proposed algorithm for the choice of IM implant for the lateral malleolus fracture in terms of the Lauge-Hansen staged classification. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
